| NPI | 1336660315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT GORDON TEICHNER Owner 843-849-9913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SC 800) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2017-06-29 |